Le nuove terapie: Laser Micropulsato
To learn more about MicroPulse, go to www.iridex.com/micropulse
For quite some time I've followed the literature on MicroPulse Laser Therapy, which has shown it to be tissuesparing to the point of allowing treatment through the fovea. This year, I started using it in my practice in patients with diabetic macular edema (DME) and patients with central serous retinopathy. Many of my MicroPulse patients are early in their treatment course for DME (I've avoided treating eyes with chronic disease). In approximately 50% of these cases, I'm seeing a treatment effect and have been pleased with the early outcomes. In the case I describe here, the patient had an incomplete response to an initial subthreshold conventional laser treatment, but has not required further treatment since one application of MicroPulse.
PATIENT PRESENTATION AND INITIAL TREATMENT
This 64-year-old male diabetic patient first required treatment for DME in his right eye at his Oct. 9, 2013 visit. On that day, slit lamp examination revealed clinically significant macular edema involving the center of the fovea. (Figure 1) Central retinal thickness (CRT) as measured by spectral-domain OCT was 413 Ám, and visual acuity was 20/40. I performed a modified focal/grid laser treatment, using a conventional green laser at subthreshold settings.
TREATMENT WITH MICROPULSE LASER THERAPY
The patient returned for follow-up on Feb. 12, 2014. The
green laser subthreshold treatment he received in his right
eye at his previous visit resulted in a decrease in CRT, from
413 Ám to 336 Ám, and accompanying improvement on the
OCT topographic map. (Figure 2) However, the macular
edema had not resolved completely. To address the
remaining edema, I performed MicroPulse with the IRIDEX
IQ 577Ö (yellow) laser. (Table 1) Rather than titrate the
treatment settings by performing a test application with
"I also used the TxCell Scanning Laser Delivery
System, which improves the consistency of highdensity
spot placement and saves time compared
with single-spot delivery."